People who have had a TIA or minor stroke are at greater risk of having another TIA or stroke. High blood pressure is often (though not always) one of the problems people need to address. Lifestyle changes can help to reduce the risks, these include:
- quitting smoking,
- reducing alcohol intake,
- maintaining a healthy weight,
- eating a healthy diet and
- taking regular exercise.
Most of the people we interviewed spoke about changes that they had made to their day to day lives which they hoped would help prevent them from having another episode, or a more serious stroke. Some people had been told by their consultant or GP that they ought to make changes, and other people took their own decision to change because they already knew about the risk factors, or had obtained information about reducing risk of further stroke from other sources e.g. internet, support organisations (see ‘
Support and information‘). However, others could not remember being given any or much advice about risk factors and lifestyle. Many people said that having a TIA or minor stroke had been a ‘wake-up call’ which had led to them thinking more about their future. For some people, changing their lifestyle also meant taking a step back from work commitments and attempting to reduce stress (see ‘
Work‘).
Diet
A number of people had been advised to lose some weight, and others were told that it was important to eat a healthy diet including cutting down on salt, sugar and fats, and eating plenty of fruit and vegetables. A good diet can help control blood pressure and reduce cholesterol levels.
Many people said they felt that they already ate reasonably healthily, but most were able to make small changes. A number of men said that their wives or partners helped them to keep their diet healthy which made it easier for them to stick to it.
Some people found change more difficult to achieve, and a small number found proposed lifestyle changes overly restrictive and could sometimes feel a bit resentful about it all.
Some people suggested that occasional treats could make it easier giving up the things you really love. A dietician may be able to advise on strategies to manage diet – though not everyone was offered this opportunity.
Smoking
Smoking causes the arteries to become narrowed and makes the blood more likely to clot, so giving up smoking is strongly recommended to avoid the risk of this happening Most of the people we interviewed who had been smokers before their TIA or minor stroke said that they gave up smoking almost immediately but one woman found it very difficult to give up because she had a bad reaction to smoking cessation medication.
Jennifer has several different illnesses which have affected her way of life and sometimes feels smoking is ‘the only pleasure I’ve really got left’.
Alcohol
Reducing alcohol levels can help to lower blood pressure. Some people said they didn’t really drink very much or not at all so this wasn’t an issue for them but a number of people said that they had taken on board the advice to cut down on alcohol consumption. Most people took on board the message that they could drink in moderation rather than stop all together.
Exercise
Regular exercise is recommended as a means of reducing the likelihood of further stroke because it can help lower blood pressure, helps you lose weight and can alter the balance of fats in the body. Thirty minutes of activity, five days a week is enough to reduce the risk of stroke. Most people said that they had been advised to take more exercise. Some said they found it relatively easy to incorporate some form of exercise in their lives especially where they now found themselves with more time on their hands through either giving up work or cutting down on the time they spent at work. Most people managed to make small changes such as walking a bit more instead of driving, and some made a conscious effort to go to gym or swimming groups but it could also be challenging for some people who were not great fans of exercise generally. Some people found it hard to keep up the momentum and said that after the first burst of enthusiasm it could be difficult to keep going with it on a regular basis. Very often someone’s wife or partner would help encourage the person to start or continue to take exercise. People who lived alone and did not have a partner to encourage them could find it more difficult to keep going. Ros (below) felt upset that nobody had acknowledged how well she was doing.
Jennifer found the costs of going to gym or exercise classes were prohibitive, and commented that it could be unfair if people who had a heart condition were given free gym sessions as part of their rehabilitation.
Some people who were very active before their TIA or minor stroke found they were unable to be quite so physically active afterwards. Yvonne (below) was very fit and active before her minor stroke and found it difficult to have to be more mindful not to over exert herself, and Ken (below) felt lost when he wasn’t able to work on the allotment as frequently as he’d been used to. Not being able to exercise so much meant some people put on weight just at a time when they wanted to lose it.